Gender differences in morbidity and mortality following a major stressor: The case of conjugal bereavement

Death of a spouse is generally considered to be the most severe stressor that people encounter during the course of their lives. Evidence has also consistently suggested that there have been gender differences in reactions to such stressors as job loss, general economic decline, and increasing crime rates in the formerly socialist countries of Central and Eastern Europe, and that exposure to such stressors is far more likely to result in enhanced mortality among men than women. The purpose of this paper is to determine whether there are similar gender differences in response to the death of a spouse. There is clear evidence that compared to married controls, widowed men are more likely to become depressed and to experience greater mortality than are widowed women. Deaths are especially likely to occur in younger bereaved men, and where the death of a wife occurred suddenly and without warning. This suggests that the shattering of hopes and expectations may be especially pathogenic for men. Major causes of death among bereaved men include alcohol-related illness, accidents and violence, suicide, and chronic ischemic heart disease. These causes of death suggest that hopelessness, or "giving up," may be a key to understanding the enhanced vulnerability of men. Several mechanisms that may account for these results are explored, including gender differences in the stressfulness of widowhood, health-promoting behavior, and coping and emotional expression following spousal loss. We conclude with a discussion of issues that will be important to pursue in subsequent research. These include study of the unique meaning that particular stressors have for men and women, and designing research that isolates and identifies the specific components of conjugal bereavement.